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Metabolic Acidosis

  • Chapter
Therapy of Renal Diseases and Related Disorders

Abstract

The acid base status of the blood is defined by its pH which represents the interrelationship among the following variables: the concentration of hydrogen ions (H+), the partial pressure of carbon dioxide (PCO2) and the concentration of bicarbonate (HCO −3 ) in blood. This relationship is expressed by the Henderson-Hasselbalch equation as follows:

$$pH = p{k_1} + \log \frac{{[HCO_3^ - ]}}{{0.03 \times PC{O_2}}}$$
([1])

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References

  1. Irving L, Chute AL: The participation of the carbonates of bone in the neutralization of ingested acid. J Cell Comp Physiol 2: 157, 1932.

    Article  CAS  Google Scholar 

  2. Gray JS: The multiple factor theory of the control of respiratory ventilation. Science 103: 739 - 744, 1966.

    Article  Google Scholar 

  3. De Sousa, Harrington JT, Ricanti E, Shelkrot JW, Schwartz WB: Renal regulation of acid-base equilibrium during chronic administration of mineral acid. J Clin Invest 53: 465 - 476, 1974.

    Article  PubMed  Google Scholar 

  4. Kunau RT: Bicarbonate reabsorption and acid excretion. In: Kurtzman NA, Martínez-Maldonado M (eds) Pathophysiology of the Kidney, Charles C Thomas Publisher, 1977, pp 275 - 290.

    Google Scholar 

  5. Tannen RL: The effect of uncomplicated potassium depletion on urine acidification. J Clin Invest 49: 813, 1970.

    Article  PubMed  CAS  Google Scholar 

  6. Tannen R, Wedell E, Moore R: Renal adaptation to a high K diet. The role of hydrogen ions. J Clin Invest 52: 2089, 1973.

    Article  PubMed  CAS  Google Scholar 

  7. Mitchell JH, Wildenthal K, Johnson R: The effects of acid- base disturbances on cardiovascular and pulmonary function. Kidney Int 1: 375 - 389, 1972.

    Article  PubMed  CAS  Google Scholar 

  8. Lloyd MH, Iles RA, Simpson BR, Strunin JM, Layron JM, Cohen RD: The effect of simulated metabolic acidosis on intracellular pH and lactate metabolism in the isolated perfused rat liver. Clin Sei Mol Med 45: 543 - 9, 1973.

    CAS  Google Scholar 

  9. Goodman AD, Lemann J, Lennon EJ, Relman AS: Production excretion and net balance of fixed acid in patients with renal acidosis. J Clin Invest 44: 495, 1965.

    Article  PubMed  CAS  Google Scholar 

  10. Emmett ME, Narins RG: Clinical use of the anion gap. Medicine 56: 38 - 54, 1977.

    PubMed  CAS  Google Scholar 

  11. McGarry JD, Foster DW: Regulation of ketogenesis and clinical aspects of the ketotic state. Metabolism 21: 471, 1972.

    Article  PubMed  CAS  Google Scholar 

  12. Bennet JL, Jr, Cary FH, Mitchell GL, et al: Acute methyl alcohol poisoning: a review based on experiences in an outbreak of 323 cases. Medicine 32: 432, 1953.

    Article  Google Scholar 

  13. Parry MF, Wallach R: Ethylene glycol poisoning. Am J Med 57: 143, 1974.

    Article  PubMed  CAS  Google Scholar 

  14. Hayward NJ, Boshell BR: Paraldehyde intoxication with metabolic acidosis. Am J Med 23: 965, 1957.

    Article  PubMed  CAS  Google Scholar 

  15. Ritz E, Heidland A: Lactic Acidosis. Clin Neph 7(5):231- 240, 1977.

    Google Scholar 

  16. Kreisbey RA: Lactate Homeostasis and Lactic Acidosis. Ann Int Med 92: 227 - 237, 1980.

    Google Scholar 

  17. Davidoff F: Guanidine derivatives in medicine. New Eng J Med 289:141, 1973,

    Google Scholar 

  18. Kreisberg RA, Owen WC, Siegal AM: Ethanol-induced hyperlacticacidemia: inhibition of lactate utilization. J Clin Invest 50: 166 - 174, 1971.

    Article  PubMed  CAS  Google Scholar 

  19. Hill JB: Salicylate intoxication. N Engl J Med 288: 1110, 1973.

    Article  PubMed  CAS  Google Scholar 

  20. Kllendorf K, Moller BB: Lactic acidosis and epinephrine poisoning. Acta Med Scand 196: 465 - 466, 1974.

    Article  Google Scholar 

  21. Field M, Block JB, Levin R, Rail DP: Significance of blood lactate elevations among patients with acute leukemia and other neoplastic proliferative disorders. Am J Med 40: 528, 1966.

    Article  Google Scholar 

  22. Craig GM, Crane CW: Lactic acidosis complicating liver failure after intravenous fructose. Br Med J 4: 211, 1971.

    Article  PubMed  CAS  Google Scholar 

  23. Levy LJ, Duga J, Girgis M, Craig JW: Ketoacidosis associated with alcoholism in non-diabetic subjects. Ann Intern Med 78: 213, 1973.

    PubMed  CAS  Google Scholar 

  24. Wrong O, Davies HEF: The excretion of acid in renal disease. Q J Med 28: 259, 1959.

    PubMed  CAS  Google Scholar 

  25. Pérez GO, Oster TR, Vaamonde CA: Incomplete syndrome of renal tubular acidosis induced by lithium carbonate. J Lab Clin Med 86: 387, 1975.

    Google Scholar 

  26. McConnell JB, Murison J, Stewart WK: The role of the colon in the pathogenesis of hyperchloremic acidosis in ureterosigmoid anastomosis. Clin Sei 57: 305, 1979.

    CAS  Google Scholar 

  27. Relman AS, Lennon EJ, Lemman J: Endogenous production of fixed acid and the measurement of the net balance of acid in normal subjects. J Clin Invest 40: 1621, 1961.

    Article  PubMed  CAS  Google Scholar 

  28. Kurtzman NA: Regulation of renal bicarbonate reabsorption by extracellular volume. J Clin Invest 49: 586, 1970.

    Article  PubMed  CAS  Google Scholar 

  29. Kurtzman NA: ‘Short-circuit’ renal tubular acidosis. J Lab Clin Med 95 (5): 633-636, 1980.

    Google Scholar 

  30. Schwartz WB, Cohen JJ: The nature of the renal responses to chronic disorders of acid-base equilibrium. Am J Med 64: 417, 1978.

    Article  PubMed  CAS  Google Scholar 

  31. Arruda JAL, Kurtzman NA: Metabolic Acidosis and Alkalosis. Clin Neph 7 (5): 201 - 215, 1977.

    CAS  Google Scholar 

  32. Kurtzman NA, White MG, Rogers PW: Aldosterone deficiency and renal bicarbonate reabsorption. J Lab Clin Med 77: 931, 1971.

    PubMed  CAS  Google Scholar 

  33. Hulter HN, Ilnicki L, Harbottle J, Sebastian A: Impaired renal H+ secretion and ammonia production in minerolo- corticoid-deficient glucocorticoid-replete dogs. Am J Physiol 232: Fl 36, 1977.

    Google Scholar 

  34. Schwartz GJ, Burg MD: Mineralocorticoid effects on cation transport by cortical collecting tubules in vitro. Am J Physiol 235: F576, 1978.

    PubMed  CAS  Google Scholar 

  35. Cruz-Soto M, Batlle D, Sabatini S, Arruda JAL, Kurtzman NA: Distal acidification in the rabbit: role of diet and blood pH. Am J Physiol 243 (Renal Huid Eletrolyte Physiol. 12) F364 - F321, 1982.

    PubMed  CAS  Google Scholar 

  36. Gougoux A, Vinay P, Lemieux G, Richardson RMA, Cheung Tam A, Goldstein MB, Stinebaugh B, Halperin ML: Effect of blood pH on distal nephron hydrogen ion secretion. Kidney Int 17: 615 - 621, 1980.

    Article  PubMed  CAS  Google Scholar 

  37. Seldin DW, Wilson JD: Renal tubular acidosis. In Stanburg JD, Wyngaarden JB, Fredrickson DS (eds). The Metabolic Basis of Inherited Disease 2nd ed. McGraw-Hill Book Co., New York, 1966, p 1230.

    Google Scholar 

  38. Arruda JAL, Kurtzman NA: Mechanisms and classification of derranged distal urinary acidification. Am J Physiol 239 (Renal Fluid Electrolyte Physiol 8): F515 - F523, 1980.

    PubMed  CAS  Google Scholar 

  39. Batlle DC: Hyperkalemic hyperchloremic metabolic acidosis associated with selective aldosterone deficiency and distal renal tubular acidosis. Seminars in Neph 1 (3): 260 - 274, 1981.

    Google Scholar 

  40. Gabow PA, Kaehny WD, Fennessey PV, Goodman SI, Gross PA, Schrier RW: Diagnostic importance of an increased serum anion gap. N Engl J Med 303: 854 - 858, 1980.

    Article  PubMed  CAS  Google Scholar 

  41. Adrogue HJ, Brensilver J, Madias NE: Changes in the plasma anion gap during chronic metabolic acid-base disturbances. Am J Physiol 235 (4): F291 - F297, 1978.

    PubMed  CAS  Google Scholar 

  42. Raradash MR, Jacobson LB: Vasodilator therapy of idiopathic lactic acidosis. N Engl J Med 293: 468, 1975.

    Article  Google Scholar 

  43. Stacpoole PW, Moore GW, Komhauser DM: Metabolic effects of Dichloroacetate in patients With diabetes mellitus and lipoproteinemia. N Engl J Med 298: 526, 1978.

    Article  PubMed  CAS  Google Scholar 

  44. Stacpoole PW, Harman EM, Curry SH, Baumgartner TG, Misbin RI: Treatment of lactic acidosis with dichloroacetate N Engl J Med 309: 390, 1983.

    Article  PubMed  CAS  Google Scholar 

  45. Tranquada RE, Bernstein S, Grant WJ: Intravenous methylene blue in the therapy of lactic acidosis. Arch Intern Med 114: 13, 1964.

    PubMed  CAS  Google Scholar 

  46. Relman AS: Lactic acidosis. In: Brenner BM, Stein JH (eds) Acid-base and Potassium Homeostasis. Churchill Livingstone, New York, 1978, p97.

    Google Scholar 

  47. Vaziri ND, Ness R, Wellikson L, Barton C, Greep N: Bicarbonate-buffered peritoneal dialysis. An effective adjunct in the treatment of lactic acidosis. Am J Med 67: 392, 1979.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. Manuel A. Cruz-Soto
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  2. Manuel Martínez-Maldonado
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Editor information

Editors and Affiliations

  1. The Bernard J. Hanley, Los Angeles, CA, 90033, USA

    Wadi N. Suki M.D. (Professor of Medicine Professor of Physiology and Biophysics Chief) (Professor of Medicine Professor of Physiology and Biophysics Chief)

  2. Division of Nephrology, University of Southern California School of Medicine, Los Angeles, CA, 90033, USA

    Wadi N. Suki M.D. (Professor of Medicine Professor of Physiology and Biophysics Chief) (Professor of Medicine Professor of Physiology and Biophysics Chief)

  3. Renal Section Baylor College of Medicine, The Methodist Hospital, Houston, TX, 77030, USA

    Shaul G. Massry M.D. (Professor of Medicine and Physiology Chief) (Professor of Medicine and Physiology Chief)

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© 1984 Martinus Nijhoff Publishing, Boston/ The Hague/ Dordrecht/ Lancaster

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Cruz-Soto, M.A., Martínez-Maldonado, M. (1984). Metabolic Acidosis. In: Suki, W.N., Massry, S.G. (eds) Therapy of Renal Diseases and Related Disorders. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-3807-9_10

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  • DOI: https://doi.org/10.1007/978-1-4613-3807-9_10

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-3809-3

  • Online ISBN: 978-1-4613-3807-9

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